Registrant Info

Spouse's Information

Spouse's First Name*

Spouse's Birth Date*

Wedding Anniversary Date*

Church Info

Church Name

Church Location

CityState

Pastor

Group Leader

Specific Housing Request

Full payment and completed registration form required: to reserve a specific housing unit you must complete this registration form along with full payment for each person requesting the unit. Please note housing is assigned as full payment is received. Some units will be reserved as much as a year in advance. We reserve the right to reassign rooms to those who have mobility needs, even if you have paid in full for that room. NOTE: This is only if absolutely necessary. We make every attempt to house you as requested when you pay in full.

1st Choice

2nd Choice

Comments or Requests

Have you previously attended a retreat, camp or other event with Cedine Ministries?

Yes

No

Camper Agreement*

I understand and agree to abide by all the camp policies

Refund and Transfer Policy*

I have read and understand the refund and transfer policy.

I agree that the submission of this online form, along with my payment, indicates that I understand the refund and transfer policy. Transfers to another retreat MUST be made at least 14 days before the registered retreat begins. The payments are transferable to another retreat this year or next year depending on availability as long as you have given a 14 day notice. You may transfer payments to an unregistered person if you are unable to attend. No payments may be transferred to a person who is already registered. If you are unable to attend, cannot transfer it to an unregistered person, and have not notified us at least two weeks prior to the retreat, your money is not refundable or transferable.

Payment

Select Amount to Pay*

Since it's before December 31, 2016, you can pay the 2016 early bird price for 2017 retreats if you pay in full.
Couples Retreat 1 - May 26, 2017 to May 28, 2017

Pay in Full - CR1 ($70 Off) - $260.00

Pay a Deposit - CR1 - $160.00

Select Amount to Pay*

Since it's before April 24, 2019, you get an early bird discount if you pay in full.
Couples Retreat 1 - May 24, 2019 to May 26, 2019

Pay in Full - CR1 ($60 Off) - $260.00

Pay a Deposit - CR1 - $160.00

Select Amount to Pay*

Couples Retreat 1 - May 24, 2019 to May 26, 2019

Pay in Full - CR1 - $320.00

Pay a Deposit - CR1 - $160.00

Select Amount to Pay*

Since it's before December 31, 2016, you can pay the 2016 early bird price for 2017 retreats if you pay in full.
Couples Retreat 2 - September 8, 2017 to September 10, 2017

Pay in Full - CR2 ($70 Off) - $260.00

Pay a Deposit - CR2 - $160.00

Select Amount to Pay*

Since it's before August 7, 2019, you get an early bird discount if you pay in full. Price is per couple.
Couples Retreat 2 - September 6, 2019 to September 8, 2019

Pay in Full - CR2 ($60 Off) - $260.00

Pay a Deposit - CR2 - $160.00

Select Amount to Pay*

Couples Retreat 2 - September 6, 2019 to September 8, 2019

Pay in Full - CR2 - $320.00

Pay a Deposit - CR2 - $160.00

Credit Card Info

American Express

Discover

MasterCard

Visa

Card NumberExpiration DateSecurity CodeCardholder Name

If you have a coupon code, enter it here

Cedine verifies coupons for each registration. If you are using a coupon without authorization, you will be responsible for full payment of fees.